Smith, Stephanie Louise, Georgopoulos, Vasileios, Ifesemen, Onosi Sylvia, James, Richard, Ferguson, Eamonn, Wakefield, Richard J., Wilson, Deborah, Buckley, Philip, Platts, Dorothy, Ledbury, Susan, Choy, Ernest  ORCID: https://orcid.org/0000-0003-4459-8609, Pickles, Tim ORCID: https://orcid.org/0000-0001-7743-0234, Rutter-Locher, Zoe, Kirkham, Bruce, Walsh, David Andrew and McWilliams, Daniel F.
2025.
Validity and contributions to pain from the central aspects of pain questionnaire in rheumatoid arthritis.
PAIN Reports
10
(4)
, e1295.
10.1097/PR9.0000000000001295
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Abstract
Introduction: The central nervous system (CNS) contributes to pain perception across musculoskeletal conditions. The central aspects of pain (CAP) questionnaire captures a single score associated with quantitative sensory testing (QST) evidence of CNS dysfunction validated in knee osteoarthritis. Objectives: Given the different pathophysiology of rheumatoid arthritis (RA), an inflammatory polyarthritis, this cross-sectional study assessed CAP's psychometric properties and its association with pain in RA. Methods: Adults with RA were recruited from Nottinghamshire, London, and Cardiff. Participants completed CAP and reported pain using a numerical rating scale. A subgroup underwent additional assessments, including quantitative sensory testing (QST; Pressure Pain detection Threshold, Temporal Summation, Conditioned Pain Modulation), Disease Activity Score-28, C-reactive protein, questionnaires addressing pain and related characteristics, and Central Sensitization Inventory short form (CSI-9). Cronbach alpha, confirmatory factor (CFA), and Rasch measurement theory assessed CAP's reliability and validity. Multivariable linear regression modelled contributions to pain by inflammation indices and CAP or CSI-9. Results: The 380 participants (73% female, median 63 years) reported average pain over the past 4 weeks of 6/10 and a CAP score of 9/16. Central aspects of pain demonstrated acceptable reliability (ICC(2,1) = 0.71), CFA fit (comparative fit index = 0.99, Tucker–Lewis index = 0.99, root mean square error of approximation = 0.034, standardized root mean residuals = 0.03), and internal consistency (α = 0.82). Central aspects of pain was significantly associated with pain (0.50 ≤ β ≤ 0.57) but not QST. Central aspects of pain explained 33% of pain variance, rising to 42% with inflammation, age, sex, and body mass index. Central Sensitization Inventory-9 correlated with pain, not QST and explained less pain variance than CAP. Conclusion: Central aspects of pain is reliable and valid for use with people with RA and explains RA pain variance better than inflammation or CSI-9.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Medicine Research Institutes & Centres > Centre for Trials Research (CNTRR) |
| Publisher: | Lippincott, Williams & Wilkins |
| ISSN: | 2471-2531 |
| Funders: | Health and Care Research Wales |
| Date of First Compliant Deposit: | 2 July 2025 |
| Date of Acceptance: | 30 March 2025 |
| Last Modified: | 03 Jul 2025 09:00 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/179468 |
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